Dynamic SPECT Case Study

Previous Studies:

• 1980: Chest oppression (2-3 times/year)
• Sep 2004: Frequent chest oppression à MPI (positive)
• Oct 2004: CAG (LAD#6: 50%, LCX#12-1: 50%, RCA#4PD: 50%)
• Feb 2016: Shortness of breath on exertion
• Apr 2016: CRBBB
• Oct 2016: Cardiac CT (Agatston score : 818.39, Difficult to distinguish due to calcification)
• Nov 2016: Symptom reduction (Flandol tape)

Coronary Angiography

Indicates no PCI; Consider CABG

• Feb 2017
• LAD#6: 75%, #7: 75%, #9-1: 75%
• LCX#11: 75%, #12-1: 90%

Perfusion Scan

Referred for stress/rest test

Coronary Flow Reserve

Abnormal response

• Mar 2017
• CFR: 1.23